Problems Scanning Related to Stunting Using Iceberg Theory Model in Salakbrojo Village Central Java
Abstract
The prevalence of stunting to date is 21,6%, which is far from target which is 14%. Research aimed to elaborate on problem of stunting using iceberg method model analysis. The research is a qualitative study with a phenomenological approach to obtain idea of stunting occurrence pattern as well as the root of problem. Data was collected by assigning focused group discussion. Correspondents were ten mothers of toddlers, five health cadres, a secretary of rural, and a rural midwife. Validity test was done by doing data source triangulation during focused group discussions. Mental model analysis was taken using directly elicited mental model technique by doing content analysis. Result of iceberg analysis found that occurrence of stunting was 3,42%. Patterns and trends include wasting 2,92%, normal nutrition 84,39%, risk of overnutrition 5,85%, overnutrition 1,95%, and obesity 1,46%. Systemic structure has shown there are relation between direct cause include lack of food intake, exclusive breastfeeding, complementary food, infectious diseases and incomplete basic immunization. Indirect causes for stunting include lack of knowledge of stunting, access of health services, house condition triggers infectious diseases and poor sanitation. The mothers’ analysis on mentality who are confident about their children being healthy and active despite nutritional problems. Mental model of health cadres, rural midwives, rural government and public health centers believe that collaboration in solving stunting problems is needed. It can be concluded that iceberg model can be applied in analyzing stunting problem and results of it can be considered in the implementation of stunting treatment.
References
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9660614/pdf/bmjopen-2022-061707.pdf
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28. Rachmawati, S., Machmud, P. B. & Hatma, R. D. Early Life Health Practice and Stunting Among Children Under-Five Years Old. Media Kesehatan Masyarakat Indonesia. 2019;15(2):120–127.
http://journal.unhas.ac.id/index.php/mkmi/article/view/6334
29. Neuhouser, M. L., Prentice, R. L., Tinker, L. F. & Lampe, J. W. Enhancing Capacity for Food and Nutrient Intake Assessment in Population Sciences Research. Annual Reviews of Public Health. 2023;44: 37–54.
https://pubmed.ncbi.nlm.nih.gov/36525959/
30. Nindyaningrum, S. F., Muniroh, L. & Rifqi, M. A. Relation of Three Basic Needs by Mother with Growth and Development of Children Age 3-5 Years in Mulyorejo Surabaya. Indonesian Journal of Public Health.2023;18(1): 93–105.
https://ejournal.unair.ac.id/IJPH/article/view/24312
31. Wardani, Z., Sukandar, D., Baliwati, Y. F. & Riyadi, H. Access to Sanitation, Smoking and Annual Parasite Incidence of Malaria as Stunting Predictors of Children Under-2 Years in Indonesia. Media Kesehatan Masyarakat Indonesia. 2020;16(1):127–139. http://journal.unhas.ac.id/index.php/mkmi/article/view/9070
32. Das, S. et al. Not Water, Sanitation and Hygiene Practice, but Timing of Stunting is Associated with Recovery from Stunting At 24 Months: Results from A Multi-Country Birth Cohort Study. Public Health Nutrition. 2021;24(6):1428–1437.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8025093/pdf/S136898002000004Xa.pdf
33. Woldesenbet, B., Tolcha, A. & Tsegaye, B. Water, Hygiene and Sanitation Practices are Associated with Stunting among Children of Age 24-59 Months in Lemo District, South Ethiopia, In 2021: Community Based Cross Sectional Study. BMC Nutrition. 2023;9(17). https://bmcnutr.biomedcentral.com/articles/10.1186/s40795-023-00677-1
34. Botero-Tovar, N., Arocha Zuluaga, G. P. & Ramírez Varela, A. Factors Influencing Delivery of Intersectoral Actions to Address Infant Stunting in Bogotá, Colombia – a Mixed Methods Case Study. BMC Public Health.2020;20(925).
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09057-x
35. Singh, S. K., Srivastava, S. & Chauhan, S. Inequality in Child Undernutrition Among Urban Population in India: a Decomposition Analysis. BMC Public Health. 2020; 20(1852). https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09864-2
36. Siddiqa, M., Zubair, A., Kamal, A., Ijaz, M. & Abushal, T. Prevalence and Associated Factors of Stunting, Wasting and Underweight of Children Below Five Using Quintile Regression Analysis (PDHS 2017–2018). Scientific Reports.2022;12(20326). https://www.nature.com/articles/s41598-022-24063-2
37. Peraturan Presiden (Perpres). Peraturan Presiden RI Nomor 72 Tahun 2021 Tentang Percepatan Penurunan Stunting. 2021; Jakarta.
2. BKKBN. Laporan Pelaksanaan Percepatan Penurunan Stunting Semester Pertama Tahun 2023.
3. Migang, Y. W., Rarome, M. J., Heriteluna, M. & Dawam, M. Intervention of Specific Nutrition and Sensitive Nutrition with Nutritional Status of Under Two-Year Infants in Family Planning Village as Efforts to Face the Demographic Bonus. Jurnal Kesehatan Masyarakat.2020; 16(1): 101–110. https://journal.unnes.ac.id/nju/index.php/kemas/article/view/23172
4. Saif, S. & Anwar, S. Unraveling The South Asian Enigma : Concurrent Manifestations of Child Anthropometric Failures and Their Determinants in Selected South Asian Countries. BMC Nutrition.2023;9(120):1-13.
https://bmcnutr.biomedcentral.com/articles/10.1186/s40795-023-00771-4
5. Badan Kebijakan Pembangunan Kesehatan. Hasil Survei Status Gizi Indonesia (SSGI) 2022.
6. BKKBN. Laporan Pelaksanaan Percepatan Penurunan Stunting Semester Pertama Tahun 2023.
7. Thordal-Christensen, H. A Holistic View on Plant Effector-Triggered Immunity Presented as an Iceberg Model. Cellular and Molecular Life Sciences.2020;77(20): 3963–3976. https://link.springer.com/10.1007/s00018-020-03515-w
8. Maxwell, J. A. & Reybold, L. E. Qualitative Research. in International Encyclopedia of the Social & Behavioral Sciences: Second Edition.2015; (Elsevier Inc.):685–689. https://linkinghub.elsevier.com/retrieve/pii/B9780080970868105586
9. Moen, K. & Middelthon, A.-L. Qualitative Research Methods. in Research in Medical and Biological Sciences 321–378 (Elsevier, 2015). https://linkinghub.elsevier.com/retrieve/pii/B9780127999432000100
10. Moon, M. D. Triangulation: A Method to Increase Validity, Reliability, and Legitimation in Clinical Research. Journal of Emergency Nursing. 2019;45(1):103–105. https://linkinghub.elsevier.com/retrieve/pii/S0099176718305889
11. Carter, N., Bryant-Lukosius, D., Dicenso, A., Blythe, J. & Neville, A. J. The Use of Triangulation in Qualitative Research. Oncology Nursing Forum. 2014;41(5):545-547. http://onf.ons.org/onf/41/5/use-triangulation-qualitative-research
12. Monat, J. P. & Gannon, T. F. The Meaning of “Structure” in Systems Thinking. Systems. 2023; 11(2).
https://www.mdpi.com/2079-8954/11/2/92
13. Doyle, E. E. H. et al. Eliciting Mental Models of Science and Risk for Disaster Communication: A Scoping Review of Methodologies. International Journal of Disaster Risk Reduction. 2022:77. https://linkinghub.elsevier.com/retrieve/pii/S221242092200303X
14. Holtrop, J. S., Scherer, L. D., Matlock, D. D., Glasgow, R. E. & Green, L. A. The Importance of Mental Models in Implementation Science. Frontier in Public Health. 2021;9 https://www.frontiersin.org/articles/10.3389/fpubh.2021.680316/full
15. Moradi, Gholami, et al. How Is the Iceberg of COVID-19? Results From a Rapid Literature Review. Medical Journal of The Islamic of The Republic of Iran. 2021;35(77). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8285553/
16. Leitao, S. et al. Maternal Morbidity and Mortality: An Iceberg Phenomenon. BJOG: An International Journal of Obstetrics and Gynaecology. 2022; 129(3):402–411. https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.16880
17. Geulayov, G. et al. Incidence of Suicide, Hospital-presenting Non-fatal Self-harm, and Community-occurring Non-fatal Self-harm in Adolescents in England (The Iceberg Model of Self-harm): A Retrospective Study. Lancet Psychiatry. 2018: 2018;5(2):167-174. https://linkinghub.elsevier.com/retrieve/pii/S2215036617304789
18. Thordal-Christensen, H. A Holistic View on Plant Effector-triggered Immunity Presented as An Iceberg Model. Cellular and Molecular Life Sciences. 2020;77(20): 3963–3976. https://link.springer.com/10.1007/s00018-020-03515-w
19. BPS Provinsi Jawa Tengah. Upah Minimum Kabupaten/Kota di Provinsi Jawa Tengah 2021-2023.
20. Baye, K., Laillou, A. & Chitweke, S. Socio-Economic Inequalities in Child Stunting Reduction in Sub-Saharan Africa. Nutrients.2020; 12:1–11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019538/pdf/nutrients-12-00253.pdf
21. Permatasari, T. A. E. & Chadirin, Y. Assessment of Undernutrition Using The Composite Index of Anthropometric Failure (CIAF) and Its Determinants: A Cross-sectional Study in The Rural Area of The Bogor District in Indonesia. BMC Nutrition. 2022;8(1). https://bmcnutr.biomedcentral.com/articles/10.1186/s40795-022-00627-3
22. Win, H. et al. Association Between Mother’s Work Status and Child Stunting in Urban Slums: S Cross-sectional Assessment of 346 Child-mother Dyads in Dhaka, Bangladesh. Archives of Public Health. 2022;80(1).
https://archpublichealth.biomedcentral.com/articles/10.1186/s13690-022-00948-6
23. Kim, J. et al. Estimating the Burden of Child Undernutrition for Smaller Electoral Units in India. JAMA Network Open. 2021;4(10). https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2785600
24. Gwelo, N. B., Sumankuuro, J., Akintola, O. & Brieger, W. R. Factors Associated with Underweight, Overweight, Stunting and Wasting Among Primary School-going Children Participating in A School Health Initiative in South Africa. BMC Nutrition. 2023;9(1). https://bmcnutr.biomedcentral.com/articles/10.1186/s40795-023-00778-x
25. Maulina, R., Qomaruddin, M. B., Kurniawan, A. W., Fernandes, A. & Astuti, E. Prevalence and Predictor Stunting, Wasting and Underweight in Timor Leste Children Under Five Years: An Analysis of DHS Data in 2016. Journal of Public Health in Africa. 2022;13 (2166). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9425938/pdf/jpha-13-22-2116.pdf
26. Dessie, G., Tsegaye, G. W., Mekonnen, B. A., Bayih, M. T. & Nigussie, Z. M. Change in Stunting and Its Associated Factors Among Children Aged Less Than 5 Years In Ethiopia Using Ethiopia Demographic and Health Survey Data From 2005 To 2019: A Multivariate Decomposition Analysis. BMJ Open. 2022;12(11).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9660614/pdf/bmjopen-2022-061707.pdf
27. Lissack, M. Understanding Is a Design Problem: Cognizing from a Designerly Thinking Perspective. Part 2. She Ji: The Journal of Economics, Design, and Innovation. 2019; 5(4):327–342. https://linkinghub.elsevier.com/retrieve/pii/S2405872619300929
28. Rachmawati, S., Machmud, P. B. & Hatma, R. D. Early Life Health Practice and Stunting Among Children Under-Five Years Old. Media Kesehatan Masyarakat Indonesia. 2019;15(2):120–127.
http://journal.unhas.ac.id/index.php/mkmi/article/view/6334
29. Neuhouser, M. L., Prentice, R. L., Tinker, L. F. & Lampe, J. W. Enhancing Capacity for Food and Nutrient Intake Assessment in Population Sciences Research. Annual Reviews of Public Health. 2023;44: 37–54.
https://pubmed.ncbi.nlm.nih.gov/36525959/
30. Nindyaningrum, S. F., Muniroh, L. & Rifqi, M. A. Relation of Three Basic Needs by Mother with Growth and Development of Children Age 3-5 Years in Mulyorejo Surabaya. Indonesian Journal of Public Health.2023;18(1): 93–105.
https://ejournal.unair.ac.id/IJPH/article/view/24312
31. Wardani, Z., Sukandar, D., Baliwati, Y. F. & Riyadi, H. Access to Sanitation, Smoking and Annual Parasite Incidence of Malaria as Stunting Predictors of Children Under-2 Years in Indonesia. Media Kesehatan Masyarakat Indonesia. 2020;16(1):127–139. http://journal.unhas.ac.id/index.php/mkmi/article/view/9070
32. Das, S. et al. Not Water, Sanitation and Hygiene Practice, but Timing of Stunting is Associated with Recovery from Stunting At 24 Months: Results from A Multi-Country Birth Cohort Study. Public Health Nutrition. 2021;24(6):1428–1437.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8025093/pdf/S136898002000004Xa.pdf
33. Woldesenbet, B., Tolcha, A. & Tsegaye, B. Water, Hygiene and Sanitation Practices are Associated with Stunting among Children of Age 24-59 Months in Lemo District, South Ethiopia, In 2021: Community Based Cross Sectional Study. BMC Nutrition. 2023;9(17). https://bmcnutr.biomedcentral.com/articles/10.1186/s40795-023-00677-1
34. Botero-Tovar, N., Arocha Zuluaga, G. P. & Ramírez Varela, A. Factors Influencing Delivery of Intersectoral Actions to Address Infant Stunting in Bogotá, Colombia – a Mixed Methods Case Study. BMC Public Health.2020;20(925).
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09057-x
35. Singh, S. K., Srivastava, S. & Chauhan, S. Inequality in Child Undernutrition Among Urban Population in India: a Decomposition Analysis. BMC Public Health. 2020; 20(1852). https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09864-2
36. Siddiqa, M., Zubair, A., Kamal, A., Ijaz, M. & Abushal, T. Prevalence and Associated Factors of Stunting, Wasting and Underweight of Children Below Five Using Quintile Regression Analysis (PDHS 2017–2018). Scientific Reports.2022;12(20326). https://www.nature.com/articles/s41598-022-24063-2
37. Peraturan Presiden (Perpres). Peraturan Presiden RI Nomor 72 Tahun 2021 Tentang Percepatan Penurunan Stunting. 2021; Jakarta.
Authors
Yuniarti, Y., Ristiawati, R., Mastuti, D. N. R. ., & Fatih, M. . (2024). Problems Scanning Related to Stunting Using Iceberg Theory Model in Salakbrojo Village Central Java. Media Kesehatan Masyarakat Indonesia, 20(2), 57-66. https://doi.org/10.30597/mkmi.v20i2.32672
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